Since 2001, endovenous laser ablation procedures have been reported to be safe and effective methods of eliminating the proximal portion of the greater saphenous vein (GSV), the small saphenous vein (SSV), and even tributary and perforator veins from the venous…
The endovascular approach to venous obstructive lesions including stenoses and chronic total occlusions (CTOs) has replaced traditional open surgery. As a result, a broader spectrum of patients with comorbidities that might otherwise preclude an open approach have benefited. In addition,…
Chronic venous disease (CVD) is the most common disorder of the peripheral vascular system. In population studies, 10% to 35% of adults manifested some form of the disease. Its most severe manifestation is cutaneous venous ulceration. CVD and related ulcers…
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The incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) has been estimated to exceed 900,000 cases annually in the United States. Upper extremity DVT can result in PE in 4% to 12% of the cases, and there are…
The options for early removal of an acute thrombus in the proximal veins of the leg are catheter-directed thrombolysis, percutaneous pharmacomechanical thrombectomy, and surgical thrombectomy. If either of the first two fail or are contraindicated, then surgical thrombectomy is a…
The postthrombotic syndrome (PTS) is a debilitating complication of iliofemoral deep vein thrombosis (IFDVT) that markedly compromises patients’ quality of life. Postthrombotic morbidity is also associated with serious socioeconomic implications. Kahn and colleagues estimated the incidence of PTS to be…
Warfarin-induced skin necrosis is a clinical–pathologic condition that arises in patients treated with vitamin K antagonists and that produces an activated blood coagulation state. The condition becomes manifest as a result of the relative loss of the protein C and…
There are many pharmacologic options in current use to treat and prevent venous thromboembolism (VTE). These medications include unfractionated heparin (UFH), low-molecular-weight heparins (LMWHs), factor Xa inhibitors (anti-Xa drugs), direct thrombin inhibitors (anti-IIa drugs), and vitamin K antagonists. UFH and…
Patients with Deep Vein Thrombosis The classic long-term treatment for deep vein thrombosis (DVT) is vitamin K–antagonist therapy overlapped with initial heparin or low-molecular-weight heparin (LMWH) therapy. Accurate, objective tests to detect venous thromboembolism (VTE) have led to randomized trials…